| 1. |
- Riikonen, Raili S, et al.
(författare)
-
Cerebrospinal nerve growth factor - A marker of asphyxia?
- 1999
-
Ingår i: Pediatric Neurology. - Univ Kuopio, Childrens Hosp, Dept Child Neurol, FIN-70211 Kuopio, Finland. Uppsala Univ, BMC, Dept Dev Neurosci, Uppsala, Sweden. : Elsevier. - 0887-8994 .- 1873-5150. ; 20:2, s. 137-141
-
Tidskriftsartikel (refereegranskat)abstract
- Asphyxia in neonates is characterized by different degrees of hypoxia-ischemia, with the outcome depending on the severity of the underlying brain cell damage. Neurotrophic factors rescue neurons from cell death after injury and promote neuronal survival during development. The authors have used enzyme-linked immunosorbent assay to study levels of nerve growth factor in the cerebrospinal fluid of children with asphyxia at birth (n = 10) and of controls (n = 23), Compared with reference groups the children who had had severe asphyxia had lower or negligible levels of cerebrospinal fluid nerve growth factor in the neonatal period or later. The level of cerebrospinal fluid nerve growth factor measured in the neonatal period was 3.76 +/- 4.13 pg/mL in children with asphyxia (n = 8), which is significantly lower than in children without asphyxia or infection (n = 10) 9.42 +/- 4.09 pg/mL or in those without asphyxia but with infection (n = 13) 17.63 +/- 11.48 pg/mL (P = 0.0186 and P = 0.0013, respectively). However, in some children with asphyxia the cerebrospinal fluid nerve growth factor levels were virtually normal, and most importantly these children subsequently had normal neurologic development. These results suggest that cerebrospinal fluid nerve growth factor might be used as a biochemical marker for early estimates of hypoxic-ischemic brain damage in asphyxiated neonates, (C) 1999 by Elsevier Science Inc. All rights reserved.
|
|
| 2. |
- Riikonen, Raili S, et al.
(författare)
-
Overstimulation of nerve growth factors in postinfectious and autoimmune diseases
- 1998
-
Ingår i: Pediatric Neurology. - Univ Helsinki, Childrens Hosp, Helsinki, Finland. Uppsala Univ, Ctr Biomed, Dept Dev Neurosci, Uppsala, Sweden. : Elsevier. - 0887-8994 .- 1873-5150. ; 18:3, s. 231-235
-
Tidskriftsartikel (refereegranskat)abstract
- Nerve growth factor (NGF) in cerebrospinal fluid was measured by ELISA in ten children with postinfectious diseases and in five children with diseases suggested to be of autoimmune etiology, Three groups of patients were studied: (1) those with moderately elevated concentrations (50.67 +/- 17.02 pg/mL, mean and SEM), (2) those with high concentrations (mean 424.25 +/- 125.41 pg/mL, mean and SEM), and (3) those with enormously high concentrations (mean 2,745 +/- 1,819.46 pg/mL, mean and SEM). We suggest that CSF-NGF could be used as an immunologic marker of an ongoing CNS process, Uncontrolled signaling of NGF receptors may lead to long-term inflammatory and autoimmune responses, which in turn can lead to disease. (C) 1998 by Elsevier Science Inc. All rights reserved.
|
|
| 3. |
- Sommerfelt, K, et al.
(författare)
-
Neuropsychologic and Motor Function in Small-for-Gestation Preschoolers
- 2002
-
Ingår i: Pediatric Neurology. - 0887-8994 .- 1873-5150. ; 26:3, s. 186-191
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate neuropsychologic and motor performance in term small-for-gestation preschool children. A patient-based sample of 311 5-year-old children with birth weights less than the fifteenth percentile for gestation was compared with a random sample of 321 appropriate-for-gestation control subjects. The main assessment tools were subscales from the Wechsler Preschool and Primary Scale of Intelligence Revised, subscales from the Illinois Test of Psycholinguistic Abilities, tests of manual dexterity and figure copying, and the Peabody Developmental Motor Scales. The small-for-gestation children had mean scores on tests of visuospatial and visuomotor abilities that were one fourth standard deviation lower than appropriate-for-gestation control subjects and slightly lower scores on manual dexterity. The small-for-gestation children were comparable to appropriate-for-gestation children regarding motor performance. We therefore conclude that the neuropsychologic and neuromotor performance in preschool years of term small-for-gestation children is reassuring.
|
|
| 4. |
- Andersson, Jacob, et al.
(författare)
-
External Hydrocephalus as a Cause of Infant Subdural Hematoma : Epidemiological and Radiological Investigations of Infants Suspected of Being Abused
- 2022
-
Ingår i: Pediatric Neurology. - : Elsevier. - 0887-8994 .- 1873-5150. ; 126, s. 26-34
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Acute subdural hematoma (ASDH) and chronic subdural hematoma (CSDH) in infants have been regarded as highly specific for abuse. Other causes of CSDH have not been investigated in a large population.Purpose: The purpose of this study was to investigate to what extent external hydrocephalus is present in infants with ASDH and CSDH undergoing evaluation for abuse.Material and methods: Eighty-five infants suspected of being abused, with ASDH (n = 16) or CSDH (n = 69), were reviewed regarding age, risk factor profiles, craniocortical width (CCW), sinocortical width (SCW), frontal interhemispheric width (IHW), subarachnoid space width (SSW), and head circumference (HC). In infants with unilateral subdural hematoma (SDH), correlations between contralateral SSW and ipsilateral CCW and SDH width were investigated.Results: Infants with CSDH had significantly lower mortality, were more often premature and male, and had significantly higher CCW, SCW, IHW, and SSW than infants with ASDH (P < 0.05). Ipsilateral CCW (R = 0.92, P < 0.001) and SDH width (R = 0.81, P < 0.01) correlated with contralateral SSW. Increased HC was more prevalent in infants with CSDH (71%) than in infants with ASDH (14%) (P < 0.01). Forty-two infants, all with CSDH, had at least one of CCW, SCW, or IHW ≥95th percentile. Twenty infants, all with CSDH, had CCW, SCW, and IHW >5 mm, in addition to increased HC.Conclusion: A substantial proportion of infants with CSDH who had been suspected of being abused had findings suggesting external hydrocephalus.
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Eeg-Olofsson, Orvar
(författare)
-
Rolandic Epilepsy
- 2010
-
Ingår i: Pediatric Neurology. - : Elsevier BV. - 0887-8994 .- 1873-5150. ; 42:3, s. 237-237
-
Tidskriftsartikel (refereegranskat)
|
|
| 8. |
- Ehrstedt, Christoffer, et al.
(författare)
-
Patient Delay, Lead Times, and Adherence to Diagnostic Guidelines in Children and Adolescents With Idiopathic Intracranial Hypertension
- 2023
-
Ingår i: Pediatric Neurology. - : Elsevier BV. - 0887-8994 .- 1873-5150. ; 148, s. 65-72
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: In a cohort of 45 children and adolescents diagnosed with idiopathic intracranial hypertension (IIH), our main aims were to investigate patient delay, lead time to final diagnosis, and adherence to current diagnostic guidelines.Methods: This population-based, retrospective, single-center cohort study was performed at Uppsala University Children's Hospital, Sweden, a tertiary referral center for children and adolescents with rare and/or complicated neurologic disease. Patient data were retrieved from the local registries for patients filling the following criteria: age (0-17.99 yr), study period (2000-2020), and International Classification of Diseases code G93.2 (IIH). Medical records from pediatric, neuropediatric, ophthalmology, and neurosurgery departments were scrutinized. All included patients met the Friedman criteria.Results: Fifty-one percent of the patients sought medical advice within 1 month of symptom debut, 23% were seen within 1 to three months, and 26% after three months. A final diagnosis of IIH was reached within 48 hours in 60%, within two weeks in 80%, and within four weeks in 89% of patients. Visual fields, color vision, and complete ancillary laboratory investigations to exclude secondary etiologies were performed in 62%, 47%, and 59% of patients, respectively.Conclusion: The clinical presentation of IIH in children and adolescents may range from acute fulminant symptoms, to a more insidious or even chronic presentation with long-term headache. Although a majority of patients received a correct and prompt diagnosis, lead time to final diagnosis and adherence to diagnostic care guidelines might be improved. A higher awareness and knowledge of the condition may achieve this.
|
|
| 9. |
|
|
| 10. |
- Hatakenaka, Yuhei, 1959, et al.
(författare)
-
Infant Motor Delay and Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations in Japan.
- 2016
-
Ingår i: Pediatric neurology. - : Elsevier BV. - 1873-5150 .- 0887-8994. ; 54, s. 55-63
-
Tidskriftsartikel (refereegranskat)abstract
- Abnormalities of early motor development have been reported in autism spectrum disorder, attention-deficit/hyperactivity disorder, intellectual developmental disorder, developmental coordination disorder, and other Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE). However, few studies have been conducted with a view to following up a clinically representative cohort of children coming for assessment of motor delay before age two years. We performed a prospective clinical cohort study to examine whether or not early motor delay is often an indication of ESSENCE.
|
|
| 11. |
|
|
| 12. |
- Power, Lisa C., et al.
(författare)
-
Exercise Cardiac Magnetic Resonance Imaging in Boys With Duchenne Muscular Dystrophy Without Cardiac Disease
- 2021
-
Ingår i: Pediatric Neurology. - : Elsevier. - 0887-8994 .- 1873-5150. ; 117, s. 35-43
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Duchenne muscular dystrophy is caused by mutations in the DMD gene, resulting in cardiomyopathy in all affected children by 18 years. Although cardiomyopathy is now the leading cause of mortality in these children, there is ongoing debate regarding timely diagnosis, secondary prevention, and treatment of this condition. The purpose of this study was to use exercise cardiac magnetic resonance imaging in asymptomatic young boys with Duchenne muscular dystrophy to describe their heart function and compare this with healthy controls.Methods: We studied 11 boys with Duchenne muscular dystrophy aged 8.6 to 13.9 years and 11 healthy age- and sex-matched controls.Results: Compared with the controls, boys with Duchenne muscular dystrophy had lower ejection fraction at rest (57% versus 63%; P = 0.004). During submaximal exercise, they reached similar peak tachycardia but increased their heart rate and cardiac output only half as much as controls (P = 0.003 and P = 0.014, respectively). End-systolic volume remained higher in boys with Duchenne muscular dystrophy both at rest and during exercise. When transthoracic echocardiography was compared with cardiac magnetic resonance imaging, 45% of the echocardiograms had suboptimal or poor views in the Duchenne muscular dystrophy group.Conclusions: Boys with Duchenne muscular dystrophy had abnormalities in left ventricular systolic function that were exaggerated by exercise stress. Exercise cardiac magnetic resonance imaging is feasible in a select population of children with Duchenne muscular dystrophy, and it has the potential to unmask early signs of cardiomyopathy.
|
|
| 13. |
|
|
| 14. |
- Saury, Jean-Michel, 1951, et al.
(författare)
-
Cognitive consequences of the treatment of medulloblastoma among children.
- 2011
-
Ingår i: Pediatric neurology. - : Elsevier BV. - 1873-5150 .- 0887-8994. ; 44:1, s. 21-30
-
Tidskriftsartikel (refereegranskat)abstract
- Progress in the treatment of medulloblastoma has resulted in increased survival among children. However, effective treatment, especially radiation therapy, produces negative consequences in the cognitive development of children, in terms of decreased intelligence quotients. Determining the factors underlying this decrease may influence the types of rehabilitation needed by children who undergo treatment for medulloblastoma. We review recent research on the impact of some factors that may underlie the cognitive deficits of pediatric and adolescent survivors, i.e., verbal comprehension, perceptual organization, attention, and processing speed. We assess eight pediatric survivors of medulloblastoma treatment with surgery, radiation, and chemotherapy. Children were assessed twice after diagnosis, using the Wechsler Intelligence Scale for Children-Third Edition. A large decrease in cognitive capacity was evident, as measured by intelligence quotients and factor indices. A raw score analysis of 12 subtests was performed, indicating a slower acquisition of functions and knowledge in the domains of verbal comprehension, perceptual organization, social perception, and psychomotor skills. We discuss issues of social reintegration, and propose that the rehabilitation of pediatric patients must include a program for social reinsertion, in addition to psychoeducational support.
|
|
| 15. |
- Shahim, Pashtun, et al.
(författare)
-
Cerebrospinal Fluid Brain Injury Biomarkers in Children: A Multicenter Study
- 2013
-
Ingår i: Pediatric Neurology. - : Elsevier BV. - 0887-8994 .- 1873-5150. ; 80
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cerebrospinal fluid (CSF) biomarkers reflecting neuronal and astroglial injury, such as total tau (T-tau), glial flbrillary acidic protein (GFAP), and neurofilament light (NFL), have been extensively investigated in neurologic diseases in adults, but no large study has investigated these biomarkers in children. METHODS: This study presents a detailed evaluation of CFS T-tau, GFAP, NFL, and CSF:albumin ratio in a large cohort of pediatric patients. This is a retrospective multicenter study on pediatric patients aged <16 years (n = 607), where neuronal injury biomarkers T-tau, GFAP, NFL, and CSF albumin ratio were analyzed during 2000-2010 at the Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Sweden. The patients were grouped into eight categories: epilepsy, infectious and inflammatory central nervous system disorders, progressive encephalopathy, static encephalopathy, tumors, movement disorders, miscellaneous disorders, and a control group. RESULTS: T-tau, GFAP, and NFL were increased in progressive encephalopathy (P < 0.001), epilepsy (P < 0.001), and infectious and inflammatory central nervous system disorders (P < 0.001) compared with controls. T-tau was the biomarker with the highest diagnostic accuracy with the area under the curve of 0.83 (95% confidence interval (CI), 0.77-0.90; P < 0.0001) for progressive encephalopathy followed by epilepsy 0.80 (95% CI, 0.75-0.87; P < 0.0001). The combination of all four biomarkers further improved the area under the curve for the progressive encephalopathy 0.87 (95% CI, 0.77-0.89; P < 0.0001), followed by epilepsy 0.81 (95% CI, 0.74-0.80; P = 0.030). The combination of the biomarkers also separated progressive from static encephalopathy 0.88 (95% CI, 0.83-0.93; P < 0.0001). CONCLUSIONS: CSF T-tau, GFAP, and NFL are differently altered across different neurologic diseases in children. Importantly, the biomarker pattern distinguishes between progressive and static neurologic disorders. (c) 2013 Elsevier Inc. All rights reserved.
|
|
| 16. |
- Söderström, Helena, et al.
(författare)
-
Neurocognitive Functions Before and After Radiotherapy in Pediatric Brain Tumor Survivors
- 2022
-
Ingår i: Pediatric Neurology. - : Elsevier. - 0887-8994 .- 1873-5150. ; 133, s. 21-29
-
Tidskriftsartikel (refereegranskat)abstract
- Background The numbers of pediatric brain tumor survivors are increasing due to improved treatment protocols and multimodal treatments. Many survivors have neurocognitive sequelae, especially after radiotherapy. Neuropsychologic assessment is therefore essential to interpret clinical outcome, evaluate treatments protocol, and implement rehabilitation interventions. The overall aim of this study was to describe neurocognitive functions before and after radiotherapy. We also aimed to explore potential confounding risk factors that could affect the interpretation of radiotherapy-induced neurocognitive decline. Methods Fifty pediatric brain tumor survivors who had received radiotherapy (five years or more ago) were included. Clinical characteristics, potential confounding risk factors, radiotherapy plans, and neurocognitive functions on intelligence quotient (IQ) and neuropsychologic measurements were analyzed before and after radiotherapy. Results Neurocognitive functions were affected before radiotherapy and were progressively aggravated thereafter. The last neuropsychologic assessment after radiotherapy varied between two and 139 months. Nineteen patients were tested five years after radiotherapy, and 90% of them performed ≥1 S.D. below the normative mean on IQ measurements. Several potential confounding risk factors including those induced by radiotherapy were associated with lower performance on perceptual function, working memory, and processing speed. Longer time after radiotherapy was particularly associated with lower performance on working memory and processing speed. Importantly, the neuropsychologic assessments revealed more comprehensive problems than could be inferred from IQ measurements alone. Conclusions Our study underpins the importance of systematic and structured neuropsychologic assessment before and after radiotherapy. The timing of the assessment is important, and potential confounding risk factors need to be identified to better evaluate radiotherapy-induced neurocognitive decline.
|
|
| 17. |
- Thordstein, Magnus, et al.
(författare)
-
Transfer of cortical motor representation after a perinatal cerebral insult.
- 2011
-
Ingår i: Pediatric neurology. - : Elsevier BV. - 1873-5150 .- 0887-8994. ; 44:2, s. 131-4
-
Tidskriftsartikel (refereegranskat)abstract
- In a 16-year-old boy with hemiplegia and severe, intractable epilepsy after a neonatal cerebral ischemic insult, cortical motor control was only equivocally assessed by functional magnetic resonance imaging. Therefore, high-precision navigated transcranial magnetic stimulation was performed, which demonstrated that cortical control of muscles on the paretic side was selectively affected. Leg muscle control was located in the contralateral hemisphere, as expected in healthy individuals, whereas forearm muscles were controlled from both hemispheres, and hand muscles were controlled only from the hemisphere ipsilateral to the paresis.
|
|
| 18. |
- Thordstein, Magnus, et al.
(författare)
-
Visual evoked potentials in disproportionately growth-retarded human neonates
- 2004
-
Ingår i: Pediatric Neurology. - : Elsevier BV. - 0887-8994 .- 1873-5150. ; 30:4, s. 262-70
-
Tidskriftsartikel (refereegranskat)abstract
- To study brain function in the neonatal period, disproportionately growth-retarded (n = 33) and appropriately grown (n = 21) infants were examined using Doppler flow velocities prenatally and visual evoked potentials postnatally. Visual evoked potentials recordings were made at gestation of 40 and 46 weeks. The group of growth-retarded infants had significantly prolonged latencies to both of the two major peaks (designated P and N), most pronounced for the P peak. This result was observed at both ages investigated and corresponds to a developmental delay of 3 weeks. For individuals, the increase in P latency correlated to prenatal flow indices and to neonatal anthropometric parameters indicative of growth retardation. We conclude that in utero growth retardation affects brain development as assessed by visual evoked potentials in the neonatal period. This developmental delay may be produced by intracerebral factors during the process of growth retardation, and these alterations may have a prognostic value.
|
|
| 19. |
|
|
| 20. |
|
|
| 21. |
|
|
| 22. |
|
|
| 23. |
|
|
| 24. |
|
|
| 25. |
- Darin, Niklas, 1964, et al.
(författare)
-
3-methylcrotonyl-CoA carboxylase deficiency and severe multiple sclerosis.
- 2007
-
Ingår i: Pediatric neurology. - : Elsevier BV. - 0887-8994. ; 36:2, s. 132-4
-
Tidskriftsartikel (refereegranskat)abstract
- This report describes a female with isolated 3-methylcrotonyl-CoA carboxylase deficiency. She had a mild Reye-like episode, loss of scalp hair, psychomotor retardation, and an attention-deficit hyperactivity disorder. The diagnosis was made at 13 years of age when she developed relapsing remitting multiple sclerosis with a malignant course. Treatment with steroids had initially a good therapeutic effect on the relapses. The response to interferon beta-1a treatment was poor. On mitoxantrone treatment there was a considerable neurologic recovery.
|
|
| 26. |
|
|
| 27. |
- Foerster, Bradley R., et al.
(författare)
-
Value of gadolinium in brain MRI examinations for developmental delay
- 2006
-
Ingår i: Pediatric Neurology. - : Elsevier BV. - 0887-8994. ; 35:2, s. 126-130
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the added utility of gadolinium administration in the magnetic resonance imaging evaluation of developmental delay in children less than 2 years of age. A computerized retrospective study identified all brain magnetic resonance imaging examinations using gadolinium performed at our institution from 1995-2002 for children under the age of 2 years. Review of the clinical records and magnetic resonance imaging reports identified 170 brain magnetic resonance imaging examinations that were performed for developmental delay. Magnetic resonance imaging studies with enhancing lesions were reviewed by two staff neuroradiologists and two radiology residents. Contrast administration was rated as essential, helpful, or not helpful for each study. In the 107 patients in whom developmental delay was the primary concern, there were no cases in which the findings would have been missed without gadolinium administration. In the 63 patients in whom developmental delay was a secondary concern, there were several cases (11%) where contrast was helpful but not essential in reaching a radiologic diagnosis. In conclusion, intravenous gadolinium has an extremely low yield in children under the age of 2 where developmental delay is the primary concern. In young children for whom developmental delay is a secondary concern, we advocate the use of gadolinium particularly where tumor or infection is clinically suspected. (c) 2006 by Elsevier Inc. All rights reserved.
|
|
| 28. |
- Gillberg, Christopher, 1950, et al.
(författare)
-
Febrile Seizures and Epilepsy: Association With Autism and Other Neurodevelopmental Disorders in the Child and Adolescent Twin Study in Sweden
- 2017
-
Ingår i: Pediatric Neurology. - : Elsevier BV. - 0887-8994. ; 74, s. 80-86
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is a recently well-documented association between childhood epilepsy and early symptomatic syndromes eliciting neurodevelopmental clinical examinations (ESSENCE) including autism spectrum disorder, but the relationship between febrile seizures and ESSENCE is less clear. METHODS: The Child and Adolescent Twin Study in Sweden (CATSS) is an ongoing population-based study targeting twins born in Sweden since July 1, 1992. Parents, of 27,092 twins were interviewed using a validated DSM-IV-based interview for ESSENCE, in connection with the twins' ninth or twelfth birthday. Diagnoses of febrile seizures (n = 492) and epilepsy (n = 282) were based on data from the Swedish National Patient Register. Prevalence of ESSENCE in individuals with febrile seizures and epilepsy was compared with prevalence in the twin population without seizures. The association between febrile seizures and ESSENCE was considered before and after adjustment for epilepsy. Age of diagnosis of febrile seizures and epilepsy was considered as a possible correlate of ESSENCE in febrile seizures and epilepsy. RESULTS: The rate of ESSENCE in febrile seizures and epilepsy was significantly higher than in the total population without seizures (all P < 0.001). After adjusting for epilepsy, a significant association between febrile seizures and autism spectrum disorder, developmental coordination disorder, and intellectual disability remained. Earlier age of onset was associated with all ESSENCE except attention-deficit/hyperactivity disorder in epilepsy but not with ESSENCE in febrile seizures. CONCLUSIONS: In a nationally representative sample of twins, there was an increased rate of ESSENCE in childhood epilepsy and in febrile seizures. Febrile seizures alone could occur as a marker for a broader ESSENCE phenotype.
|
|
| 29. |
|
|
| 30. |
|
|
| 31. |
- Håkansson, Samuel, 1996, et al.
(författare)
-
Selection and continuation of antiseizure medication in children with epilepsy in Sweden 2007-2020
- 2023
-
Ingår i: Pediatric Neurology. - : Elsevier BV. - 0887-8994. ; 144, s. 19-25
-
Tidskriftsartikel (refereegranskat)abstract
- Knowledge on anti-seizure medication (ASM) use and retention for children with epilepsy is limited, partly because of extensive off-label use of newer drugs with limited registration. We used prescription data to study prescription patterns on a population-wide scale and compared the proportion of patients remaining on monotherapy of ASMs with and without formal indication for different age groups. 14681 individuals <18 years of age were included, using cross-referenced Swedish registers from 2007-2020. Kaplan-Meier retention rate were calculated for all ASMs. The most common pathways of the first three medications per patient were analyzed. In children older than 1 month and up to 1 year of age, monotherapy retention rates were highest for oxcarbazepine, valproic acid, and carbamazepine. Among children aged 1-5 years, oxcarbazepine and levetiracetam were among ASMs that do not have a monotherapy indication in Sweden but still had high retention rates. In the age group 5-12 years, lamotrigine and oxcarbazepine had the highest retention rate. In males aged 12-18 years, valproic acid was the most common choice followed by lamotrigine, whereas lamotrigine was the first choice of ASM for females, exceeding the second and third most common options levetiracetam and oxcarbazepine by a factor of two and three, respectively. Off-label medication is common in children with epilepsy but does not seem to be associated with lower retention. The restrictions regarding valproic acid for females of childbearing age seem to have been well implemented in Swedish neuropediatric care.
|
|
| 32. |
- Irestorm, Elin, et al.
(författare)
-
Pretreatment Cognition in Patients Diagnosed With Pediatric Brain Tumors
- 2018
-
Ingår i: Pediatric Neurology. - : Elsevier BV. - 0887-8994. ; 79, s. 28-33
-
Tidskriftsartikel (refereegranskat)abstract
- Background: There is a large body of literature identifying risk factors for the long-term cognitive alterations found in survivors of pediatric brain tumors. Less is known about baseline cognitive functioning in this population, but studies suggest that cognitive dysfunctions are often present at the time of diagnosis. This study aimed to identify potential risk factors for lower cognitive function at the time of pediatric brain tumor diagnosis. Methods: Participants were children and adolescents (n = 101) diagnosed with a pediatric brain tumor between 2006 and 2015, who underwent a pretreatment neuropsychologic assessment. Multivariate regression models were used to estimate the association between gender, age at diagnosis, tumor size and location, increased intracranial pressure, epilepsy, and six different indicators of cognitive functioning. Results: Overall, cognitive performance was relatively intact, with results close to norm means, but impairments were found in memory and cognitive processing speed. Male gender, older age, epilepsy, increased intracranial pressure, and larger tumors were all associated with lower cognitive function at the time of brain tumor diagnosis; whereas tumor location was not. Conclusions: Pretreatment neuropsychologic assessments, with some adjustments, can be carried out with children and adolescents with brain tumors. Our study adds to a small but growing body of literature documenting cognitive impairments at the time of diagnosis; these impairments may partly explain the longer-term deficits that commonly occur in pediatric brain tumor survivors. Consistent with previous research, pretreatment impairments were more common among boys, older children, and those with increased intracranial pressure, epilepsy, and larger tumors. The relationship between baseline and longer-term cognitive deficits requires further examination.
|
|
| 33. |
- Janzing, Anna M, et al.
(författare)
-
Clinical Characteristics Suggestive of a Genetic Cause in Cerebral Palsy : A Systematic Review
- 2024
-
Ingår i: Pediatric Neurology. - 0887-8994. ; 153, s. 144-151
-
Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Cerebral palsy (CP) is a clinical diagnosis and was long categorized as an acquired disorder, but more and more genetic etiologies are being identified. This review aims to identify the clinical characteristics that are associated with genetic CP to aid clinicians in selecting candidates for genetic testing.METHODS: The PubMed database was systematically searched to identify genes associated with CP. The clinical characteristics accompanying these genetic forms of CP were compared with published data of large CP populations resulting in the identification of potential indicators of genetic CP.RESULLTS: Of 1930 articles retrieved, 134 were included. In these, 55 CP genes (described in two or more cases, n = 272) and 79 candidate genes (described in only one case) were reported. The most frequently CP-associated genes were PLP1 (21 cases), ARG1 (17 cases), and CTNNB1 (13 cases). Dyskinesia and the absence of spasticity were identified as strong potential indicators of genetic CP. Presence of intellectual disability, no preterm birth, and no unilateral distribution of symptoms were classified as moderate genetic indicators.CONCLUSIONS: Genetic causes of CP are increasingly identified. The clinical characteristics associated with genetic CP can aid clinicians regarding to which individual with CP to offer genetic testing. The identified potential genetic indicators need to be validated in large CP cohorts but can provide the first step toward a diagnostic algorithm for genetic CP.
|
|
| 34. |
- Lindström, Katarina, et al.
(författare)
-
Teenage outcome after being born at term with moderate neonatal encephalopathy.
- 2006
-
Ingår i: Pediatric Neurology. - : Elsevier BV. - 0887-8994. ; 35:4, s. 268-74
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to assess cognitive functions and behavior problems in teenagers who survived moderate neonatal encephalopathy and did not develop cerebral palsy. The study population comprised all 97,468 individuals born in Sweden in 1985. Of these, 684 (0.7%) were born at term and had an Apgar score of <7 at 5 minutes. The obstetric and neonatal records were scrutinized and the individuals were classified according to degree of neonatal encephalopathy. Teenagers with moderate neonatal encephalopathy without cerebral palsy and other major neuro-impairments were subjected to a clinical assessment including interviews, neuropsychological tests, and assessments of data from records. Age at examination was 15-19 years. Fifty-six individuals who had moderate neonatal encephalopathy were identified. Thirteen (23%) had parents who declined participation in the study. Of the remaining 43 subjects, 15 (30%) had a diagnosis of cerebral palsy or other major neuro-impairments and 28 had no such impairments. The latter group was examined, 20 of whom (71%) had definite cognitive dysfunctions. Five (18%) had hearing impairments. Only eight teenagers were without impairments. Of those who did not have cerebral palsy, the majority had cognitive/executive problems that interfered with their daily life situation. Clinical follow-up, including assessments of cognitive functions before school start, should be considered for all individuals in this high-risk group.
|
|
| 35. |
- Ljungblad, Ulf Wike, et al.
(författare)
-
Breastfed Infants With Spells, Tremor, or Irritability : Rule Out Vitamin B12 Deficiency
- 2022
-
Ingår i: Pediatric Neurology. - : Elsevier BV. - 0887-8994. ; 131, s. 4-12
-
Tidskriftsartikel (refereegranskat)abstract
- Background: In Norway, 5-10% of neonates and infants have biomarkers suggesting vitamin B12 deficiency from newborn screening tests and unselected clinical screening, respectively. Aims: The aims were to identify risk factors and describe presenting symptoms and biochemical profiles in infants diagnosed with vitamin B12 deficiency. Methods: In this case-control study, we searched hospital medical records for infants younger than one year born in 2011-2018, diagnosed with vitamin B12 deficiency. We compared 85 cases with a control group of 252 infants aged 3-7 months. Parents completed questionnaires. Results: Of the 85 cases with vitamin B12 deficiency, 80% presented with spells (37%) of apneas, motor seizures, or absences within the first two months of life. Tremor (29%) and irritability (18%) were the most common findings at the first examination. Serum total homocysteine ≥10 μmol/L was found in 77% of cases compared to 28% of controls (P < 0.001). None of the mothers were vegetarians, but 25% reported a previous history of vitamin B12 deficiency and 7% had celiac disease. The dose of nitrous oxide given during labor was significantly associated with infant serum total homocysteine level at diagnosis (r = 0.37, 95% confidence interval = 0.16-0.55, P < 0.001) for cases, but not for controls. Conclusion: Spells, tremor, and irritability are common findings in early infant vitamin B12 deficiency. Nitrous oxide given during labor is proposed as a contributing risk factor to the development of early infant vitamin B12 deficiency.
|
|
| 36. |
|
|
| 37. |
|
|
| 38. |
|
|
| 39. |
- Steffenburg, Suzanne, et al.
(författare)
-
Autism in Angelman syndrome: a population-based study.
- 1996
-
Ingår i: Pediatric Neurolgy. - 0887-8994. ; 14:2, s. 131-136
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine the prevalence of angelman syndrome in prepubertal school-aged children and analyze its comorbidity with autistic disorder. A clinical/psychiatric evaluation of a population-based sample of 6- to 13-year-old mentally retarded children with active epilepsy was performed. Four individuals in a total population of almost 49,000 children conformed to the clinical diagnosis of Angelman syndrome. Two of these had a typical microdeletion at chromosome 15q11-13. The minimum prevalence of Angelman syndrome was estimated at 0.008% (1: 12,000) in the examined age group. All 4 children with Angelman syndrome met full behavioral criteria for the diagnosis of autistic disorder/childhood autism. It is concluded that Angelman syndrome is uncommon, but more frequent than previously estimated. The diagnosis should be considered in all patients with combined autistic disorder, severe mental retardation, and epilepsy. The implications of the possible association of Angelman syndrome and autism are discussed
|
|
| 40. |
- Tonning Olsson, Ingrid, et al.
(författare)
-
Access to Neuropsychologic Services After Pediatric Brain Tumor.
- 2013
-
Ingår i: Pediatric Neurology. - : Elsevier BV. - 0887-8994. ; 49:6, s. 420-423
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Increasing survival rates for pediatric brain tumor patients creates a greater need for neuropsychologic follow-up and intervention. The aim of this study was to evaluate rates of referral by medical doctors to neuropsychologic services and patient and treatment factors that differentiated referred and non-referred patients. Methods: Data were retrieved from medical records of all pediatric brain tumor patients in Southern Sweden diagnosed between 1993 and 2004 who survived more than one year (n=132). Characteristics of the patients, the cancer, and treatment received were then compared for patients who were and were not referred for neuropsychologic examination during that period. Results: Sixty-four (48%) of the pediatric brain tumor patients were referred for neuropsychologic evaluation. These patients had significantly larger tumors, more recurrences of cancer, and increased intracranial pressure at diagnosis when compared to the non-referred group (n=68). However most of the patients in the non-referred group either had risk significant factors for cognitive impairment or were reporting impairments that would suggest a referral was warranted. Conclusions: Given the high rates of cognitive impairment found in patients with pediatric brain tumors, survivors should be referred to neuropsychologic services. In addition to improving long-term adjustment, systematic referral can provide data on cognitive impairments that may inform cost-benefit-analyses when deciding on various treatments at the point of diagnosis. Greater efforts are needed to disseminate and raise awareness about published guidelines on the long-term care of pediatric brain tumor patients.
|
|
| 41. |
- Tonning Olsson, Ingrid, et al.
(författare)
-
Long-Term Cognitive Sequelae After Pediatric Brain Tumor Related to Medical Risk Factors, Age, and Sex
- 2014
-
Ingår i: Pediatric Neurology. - : Elsevier BV. - 0887-8994. ; 51:4, s. 515-521
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Young age at diagnosis and treatment with cranial radiation therapy are well studied risk factors for cognitive impairment in pediatric brain tumor survivors. Other risk factors are hydrocephalus, surgery complications, and treatment with intrathecal chemotherapy. Female gender vulnerability to cognitive sequelae after cancer treatment has been evident in some studies, but no earlier studies have related this to tumor size. The purpose of our study was to find factors correlated with lowered IQ in a nationally representative sample of pediatric brain tumor patients referred for neuropsychologic evaluation. METHODS: Sixty-nine pediatric brain tumor patients, diagnosed 1988-2005 and tested 1995-2006, were included in the study. In a series of stepwise multiple regressions, the relationship of IQ to disease, treatment, and individual variables (sex and syndromes) were evaluated. A subanalysis was made of the covariation between sex and tumor size. RESULTS: The patients had generally suppressed IQ and impairments in executive function, memory, and attention. Lowered IQ was associated with young age at diagnosis, being male, tumor size, and treatment with whole-brain radiation therapy. A sex difference was evident for patients with increased intracranial pressure at diagnosis with males having larger tumors. Tumor size was found to be a better predictor of cognitive sequelae than sex. CONCLUSIONS: Whole-brain radiation therapy, large tumors, young age at diagnosis, and male gender are risk factors for late cognitive sequelae after pediatric brain tumors. When examining sex differences, tumor size at diagnosis needs to be taken into account.
|
|
| 42. |
- Yuan, X., et al.
(författare)
-
Early Amplitude-Integrated Electroencephalography Predicts Long-Term Outcomes in Term and Near-Term Newborns With Severe Hyperbilirubinemia
- 2019
-
Ingår i: Pediatric Neurology. - : Elsevier BV. - 0887-8994. ; 98, s. 68-73
-
Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to determine the predictive neurological prognostic value of early amplitude-integrated electroencephalography (aEEG) in term and near-term neonates with severe hyperbilirubinemia compared with cranial magnetic resonance imaging (MRI) and auditory brainstem response (ABR). Methods: Infants of >= 35 weeks of gestation with severe hyperbilirubinemia (total serum bilirubin [TSB] 340 mu mol/L) or with hyperbilirubinemia (TSB >= 257 mu mol/L) in association with bilirubin-induced neurological dysfunction were recruited. All the subjects had an aEEG after being admitted to the neonatal intensive care unit, whereas cranial MRI and ABR were performed when TSB had come down to the normal range. All the infants were followed up to 12 months. Results: During the study period, 77 of 83 infants were eligible, of which 71 had severe hyperbilirubinemia and six had hyperbilirubinemia in association with bilirubin-induced neurological dysfunction. Thirty-three infants were diagnosed with acute bilirubin encephalopathy (ABE), two of whom died of ABE, and 62 completed the follow-up, of which 12 infants had adverse outcomes. Sixtyfour infants underwent aEEG, 40 infants had cranial MRI, and 39 infants had ABR. Logistic regression and the receiver-operator characteristic curve analysis showed that the ability of severely abnormal aEEG to predict adverse neurological outcomes in severe hyperbilirubinemia was no better than abnormal ABR, with a sensitivity of 35.7% versus 83.3%, a specificity of 92.0% versus 74.1%, a positive predictive value of 55.6% versus 58.8%, and a negative predictive value of 83.6% versus 90.9%. Conclusions: Early aEEG could predict adverse neurodevelopmental outcomes in neonates with severe hyperbilirubinemia, although the sensitivity was lower than ABR. (C) 2019 The Authors. Published by Elsevier Inc.
|
|
| 43. |
- Bergström, Dan
(författare)
-
Productivity of harvesting dense birch stands for bioenergy
- 2016
-
Ingår i: Biomass and Bioenergy. - : Elsevier BV. - 0961-9534 .- 1873-2909. ; 88, s. 142-151
-
Tidskriftsartikel (refereegranskat)abstract
- Marginal lands could be utilized for increasing energy biomass production independent of industrial roundwood procurement. Dedicated energy biomass production systems on such sites would be based on low stand establishment cost, clear-cutting at an early stage, and coppice regeneration. Harvesters designed for the processing of industrial roundwood are inefficient or too costly to use in small-diameter and dense stands, while insufficient cutting capacity and uneven space distribution of trees limit the use of modified agricultural harvesters developed for short-rotation woody-crop plantations (e.g. willow). We constructed time consumption models for clear-cutting and forwarding of whole trees from unthinned, small-diameter stands. The data originated from naturally afforested downy birch-dominated stands located in a cutaway peat production area in northern Finland. Stand age varied from 14 to 29 years and stand density was 5150-160,250 trees per hectare. In clear-cutting, a medium-sized forest harvester equipped with an accumulating felling head fitted with a circular saw disc was used, and subsequent forwarding was done using a modified medium-sized forwarder. Cutting productivity was 3-11oven-dry tons (ODt) per effective hour (E-0-h), and was highly dependent on stand characteristics (e.g. mean whole-tree volume). At a distance of 300 m, for example, the productivity of forwarding in the time study plots was 6.7-10.4 ODt E-0-h(-1). Our study indicates that energy biomass can be harvested from young downy birch thickets efficiently by clear-cutting with appropriate machinery. (C) 2016 Published by Elsevier Ltd.
|
|
